Samuel James Kelly III, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

07874 Issued in MD

Practice address

8320 Bellona Ave Ste 240
Towson, MD 21204-2093

Phone

(410) 498-4625

Fax

(410) 498-4665

NPI assigned

Jul 28, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767916800000",
    "number": "1174523377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3316 BATAVIA AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212142609",
            "telephone_number": "410-371-6740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8320 BELLONA AVE STE 240",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212042093",
            "telephone_number": "410-498-4625",
            "fax_number": "410-498-4665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "SAMUEL",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2026-01-09",
        "certification_date": "2026-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "07874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Clark Keller Sr., D.D.S.
• John J Kelley Jr., BCO
• Christine M Kellner, CRNA
• Debra A Kelly, CRNA
• Gail Henri Kelly, CRNP-FAMILY
• Alan Kelman, M.D.
• Ashley Kelsey, RD, LDN
• Shannon Kelso, DNP, CRNP-PMH, PMHNP
• Raechelle Lynn Kempfer, NP
• Ken Zeigler, LLC

• Clinical Social Worker in Towson, MD
• Providers in Towson, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.